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Hypoparathyroidism
Hypoparathyroidism is a rare condition where the parathyroid glands, which are in the neck near the thyroid gland, produce too little parathyroid hormone.
This makes blood calcium levels fall (hypocalcaemia) and blood phosphorus levels rise (hyperphosphataemia), which can cause a wide range of symptoms, including muscle cramps, pain and twitching.
Treatment for hypoparathyroidism involves taking supplements, usually for life, to restore calcium and phosphorus levels.
Symptoms of hypoparathyroidism
The symptoms of hypoparathyroidism can include:
a tingling sensation (paraesthesia) in your fingertips, toes and lips
twitching facial muscles
muscle pains or cramps, particularly in your legs, feet or tummy
tiredness
mood changes, such as feeling irritable, anxious or depressed
dry, rough skin
coarse hair that breaks easily and can fall out
fingernails that break easily
Diagnosing hypoparathyroidism
Hypoparathyroidism is diagnosed after a blood test has shown:
low parathyroid hormone levels
low calcium levels
high phosphorus levels
Treating hypoparathyroidism
Treatment for hypoparathyroidism aims to relieve your symptoms and bring the levels of calcium and other minerals in your blood back to normal.
The normal calcium range is around 2.2 to 2.6 millimoles per litre (mmol/L). You'll be advised to keep your calcium levels in a slightly lower range – for example, 1.8 to 2.25mmol/L. Your recommended range will depend on your circumstances.
Calcium carbonate and vitamin D supplements – usually calcitriol (Rocaltrol) or alfacalcidol (One-Alpha) – can be taken to restore your blood calcium to these levels. They usually have to be taken for life.
You'll also need to have regular blood tests to monitor your parathyroid hormone, calcium and phosphorus levels.
If your blood calcium levels fall to a dangerously low level or you keep having muscle spasms, you may need to be given calcium through a drip directly into your vein.
Dietary advice
It's also recommended that you follow a high-calcium, low-phosphorus diet.
Good sources of calcium include:
milk, cheese and other dairy foods
leafy green vegetables, such as broccoli, cabbage and okra – but not spinach
soya beans
tofu
soya drinks with added calcium
nuts
bread and anything made with fortified flour
fish where you eat the bones, such as sardines and pilchards
Phosphorus is found in:
red meat
dairy
fish
poultry
bread
rice
oats
Causes of hypoparathyroidism
The most common cause of hypoparathyroidism is removal of or accidental injury to the parathyroid glands during surgery to the neck.
Other causes include:
autoimmune conditions, where the body mistakenly attacks its own tissues – such as Addison's disease and pernicious anaemia
being born without parathyroid glands or with glands that don't work properly – for example, people with the inherited genetic disorder DiGeorge syndrome can have underdeveloped parathyroid glands
radiotherapy to treat throat or neck cancer
low blood magnesium levels – for example, because of alcohol misuse
Page last reviewed: 01 April 2021
Next review due: 01 April 2024
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